Managing Fungating Wounds

Managing fungating wounds can be challenging for nurses, especially in terms of implications for patients and of quality of care. These wounds can spread rapidly, either as a primary, metastatic or recurrent malignancy, and are often associated with breast or head and neck cancers.

The physical and psychological impact of the wound on day-to-day living can be enormous, with subsequent quality of life issues. Malodour, offensive exudate, pain and discomfort, infection, and bleeding are some of the problems experienced by patients. Oozing wounds cause anxiety about seepage. They can prevent women from wearing feminine clothes and can effect some people's need for physical closeness and sexual intimacy. Holistic psychosocial support of patients and families is required along with physical care.

Some nurses have experience in the management of these types of wounds, but others may have to seek expert help. This help may come from specialist palliative care nurses or from wound management specialists. Effective wound assessment, use of appropriate dressings and symptom management are vital.